A loss of skeletal muscle mass independently predicted mortality and the risk for sepsis in live-donor liver transplantation recipients, according to new data.
Researchers in Japan evaluated 204 patients (50.4% men) within 1 month before living-donor liver transplantation (LDLT), measuring muscle mass along the psoas muscle using computed tomography (CT) scans.
Forty-seven percent of patients were diagnosed with sarcopenia, defined as a psoas muscle area lower than the 5th percentile for healthy donors of each sex. Sarcopenia was found in 58.3% of men and 35.6% of women during the November 2003 to December 2011 study period. Risk for death among sarcopenia patients was twice as high (HR=2.06; 95% CI, 1.01-4.2) compared with those without muscle loss. Sarcopenia also was independently linked to overall survival and a predictor of postoperative sepsis (HR=5.31; 95% CI, 1.53-18.4).
After providing enteral nutrition support within the first 48 hours after LDLT, the rate of sepsis dropped from 28.2% in 2003-2007 to 10.5% in 2008-2011 (P=.03) among transplantation candidates.
“Sepsis was reduced in patients with sarcopenia when nutritional intervention was used,” researcher Ken Shirabe, MD, PhD, department of surgery and sciences, Kyushu University, said in a press release. “Treatment of malnutrition in transplant candidates may reduce the risk of death following transplantation, but larger studies are needed to confirm this evidence.”
Disclosure: The researchers report no relevant financial disclosures.